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United Nations Vow to Combat Lifestyle-Related Diseases Worldwide

For only the second time in its history, the General Assembly of the United Nations (UN) gathers this week to discuss an urgent issue of health. The last time was ten years ago when the UN confronted the growing threat of the AIDS pandemic. Common chronic illnesses, a.k.a. non-communicable diseases (NCDs), like obesity, diabetes, heart disease and cancer, many of which are acquired by poor lifestyle choices, are now at the forefront of health concerns in the world. The goal of the meeting is to adopt a concise, action-oriented document that can shape a global agenda for the improvement of people’s health and quality of life.

About 36 million people die every year from NCDs, almost 80 percent of them in poor countries where access to preventive health care measures like early diagnosis, treatment and education is very limited. Campaigns to reduce smoking rates, improving diets, encouraging exercise and making more life-saving drugs available at affordable prices would make a real difference in many of these places.

There is a common story around tobacco, alcohol, diet and exercise. By addressing these issues and finding better solutions to fight their impact on people’s health would be both significant and cost-effective, according to David Kerr, president of the European Society of Medical Oncology.

The focus at the UN meeting will be on fatty foods, sugary drinks and, above all, tobacco use. Cigarette smoking alone will kill more than billion people worldwide in this century if current trends persist, according to estimates by the World Health Organization (WHO).

Still, many governments will find it hard to implement more draconian measures to reduce smoking in their countries. In Japan, for example, 50 percent of the tobacco industry is owned by the state. In China, where a third of all smokers in the world live, sales from the state-run tobacco industry account for nine percent of fiscal revenues. And here in the U.S., cigarette makers continue to rake in robust profits, if not from the domestic market then certainly from exports.

So it should not come as a surprise that after months of tough negotiations only a much watered-down compromise could be found to which a majority of nations would be willing to commit. Among the surviving intentions are: A pledge to institute a global monitoring framework within the UN that will assess future developments in the spread of diabetes, cardiovascular disease, respiratory disease and various types of cancer. There will also be a catalogue of recommendations for actions to be taken by individual governments to reduce NCDs and related risk factors. If this sounds somewhat vague, it’s because it is.

Yet the UN is lucky to have come this far. Diplomats involved in the preliminary drafting of the agenda reported that negotiations stalled several times because of heavy lobbying efforts by food, tobacco and drug industries, according to the British Medical Journal.

Funding is a major concern. It is still unclear how the planned monitoring- and promotional measures will be financed. The WHO may end up having to ask wealthier governments to raise funds, for example by imposing higher taxes on tobacco and sodas, to support the efforts of poorer nations. At this time, even the most optimistic health advocates don’t dare to hope for funding on par with the resources that were provided for the global fight against AIDS in 2001.

Unlike AIDS, which until recently was an almost certain death sentence for those affected with the disease, NCDs are not commonly seen as an immediate threat to the survival of large parts of the world population. Stopping people from smoking or providing cheap drugs like aspirin or statins to prevent heart attacks and strokes may be easy and cost-effective by comparison, but simple measures like these don’t provide many incentives for governments and private sectors to invest. “The time horizon for the return on that investment is very long and beyond many political horizons,” said Dr. Gordon Tomaselli, president of the American Heart Association (AHA). “So it’s difficult to get people to commit to these kinds of resources.”

Nevertheless, a complete failure to come to some consensus about the seriousness of the NCDs crisis and the necessity for counteraction would be tragic. “A major opportunity to advance global health is in danger of being lost if substantive targets are not set and nations don’t agree to be held accountable for meeting them,” warned the medical journal, “The Lancet,” in a recent editorial (30/16/2011).

If not much else, at the very least, the meeting, which will be attended not only by expert representatives but also heads of state, will help to raise awareness and remove some of the stigma that is often associated with obesity and other lifestyle-related diseases. The world needs to know that this is no longer a matter of personal choices but a menace to public health that would be perfectly preventable if the right policies were put in place.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” ( http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Note: This is a seattlepi.com reader blog. It is not written or edited by the P-I. The authors are solely responsible for content. E-mail us at newmedia@seattlepi.com if you consider a post inappropriate.